14 FUTURE OFDENTISTRY
Vision and Recommendations
Employer-Based Dental Benefits.....................................................................................................
Major changes in employer funding of dental
benefits are expected. Higher medical costs and com-
petitive pressures will lead to more defined contribu-
tion programs, more voluntary programs, greater
employee cost sharing, and optional coverage for
retirees. These changes will impact the use of dental
services and the mix of services. Third party payments
are simply a means of helping fund dental care. They
must never inappropriately influence the dentist's diag-
nosis and treatment recommendations.
Financing Recommendation-1:The dental benefits
industry should explore a market-oriented solution
to financing dental services which would include tax
deferred dental/medical savings accounts and direct
reimbursement plans.
Financing Recommendation-2:Financing of dental
services should be structured so it will not inappro-
priately interfere with the professional judgment of
the dentist or create unwarranted intrusion into the
decisions reached jointly by dentists and patients
regarding appropriate and best treatment options.
Radical changes in the health care delivery system
have often left patients in positions where they feel
defenseless in their attempts to receive quality care.
In many cases this can be directly traced to unwar-
ranted intrusion by third parties into the doctor/
patient relationship. To remedy this situation na-
tional legislators have sought to initiate actions that
would give Americans access to responsible care.
Organized dentistry has been a pacesetter in the
struggle to ensure that patients have the right to
choose health providers within a plan; have the
option of joining a point-of-service-plan outside the
network; be assured of prompt care; have access to
care within reasonable distances from their home;
and have the ability to pursue legal action against
negligent health plans.
Financing Recommendation-3: The professional
dental communities must continue their support of
national legislation that will protect patients from
health plans that place bottom-line profit ahead of
quality and access to care. Even after passage of
such legislation, the profession must remain vigilant
in ensuring that the intent of the legislation is not
undermined.Financing Recommendation-4: The dental profes-
sion should develop an active campaign to educate
employers and employees regarding dental benefits
choices so they can become better health care con-
sumers. This campaign should include dentists as
members of the educational team.Innovation in Dental Financing Arrangements................................................................................
Patients are experiencing greater limitations,
restrictions, exclusions, larger co-payments, static
maximums, and administrative problems which are
contributing to their growing frustration. If these
factors continue and are not corrected, they will
lead to growing dissatisfaction on the part of
patients; some may be unwilling to continue their
dental insurance plans. Changes in technology, dis-
ease patterns and demographics may stimulate
development of new dental benefit programs that
would have different reimbursement methods,
incentives and covered benefits. These changes
could impact the types of services provided.
Innovative dental insurance programs should be
developed to respond to these changes.Financing Recommendation-5: The dental profes-
sion should encourage the dental benefits industry
to streamline procedures, reduce administrative bur-
den and policy limitations, and provide greater flex-
ibility for covered individuals in their reimburse-
ment for dental services.Dentists are reporting increasing frustration in
dealing with dental benefits companies. A growing
number of dentists are distancing themselves from
dental insurance companies proclaiming themselves to
be "insurance free." Bureaucratic and administrative
problems, excessive and time consuming paperwork
and telephone activity, "lost" submitted forms and
radiographs, interference with treatment, fee restric-
tions and payment delays are among the reasons cited.
It is difficult to determine how significant the “insur-
ance free” trend will become, but it appears to be